Dilmy, Mohammad Adya Firmansha
Maternal-Fetal Division Department Of Obstetrics And Gynecology, Faculty Of Medicine Universitas Indonesia Dr. Cipto Mangunkusumo Hospital Jakarta

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Maternal outcome in accreta cases. Conservative surgery and hysterectomy in Cipto Mangunkusumo General Hospital, Jakarta, Indonesia, from January 2017 to January 2018 Fita Maulina; Mohammad Adya Firmansha Dilmy; Yudianto Budi Saroyo; Yuditiya Purwosunu
Majalah Obstetri dan Ginekologi Vol. 29 No. 3 (2021): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V29I32021.129-135

Abstract

HIGHLIGHT1. As the incidence of placenta accreta is increasing which seems to parallel the increasing cesarean delivery rate, advance planning should be made for the management of delivery. 2. Maternal outcome of placenta accreta cases in a national hospital was reported based on the surgical technique performed.3. No significant results of maternal outcome undergoing conservative surgery and conventional hysterectomy in managing accreta cases in the national hospital.ABSTRACTObjectives: To report maternal outcome based on surgical technique on the management of accreta. The study was conducted in Cipto Mangunkusumo Hospital, Jakarta, Indonesia from January 2017 to January 2018.Case Report: There were 1609 cases of pregnant women delivered during the study period. From these, the prevalence of previous caesarean section was 73 cases, including 20 cases of accreta. Total maternal mortality for 1 year in Cipto Mangunkusumo Hospital, Jakarta, Indonesia, was 11, and accreta contributed 3 cases. We reported 20 cases of accreta in pregnancy The maternal outcomes, including bladder injury, duration of operation, intraoperative bleeding, length of hospitalization, and mortality, were evaluated. From 20 cases, 8 patients had one previous caesarean history, 11 had second previous caesarean section, while 2 patient had third previous caesarean section history. Of women with placenta accreta, about 7 patients (35%) had delivery in fullterm pregnancies, while 13 (65%) had delivery in preterm pregnancy. Surgical technique in accreta management mostly was hysterectomy to override bleeding complication along the delivery. From 20 cases, 16 caesarean sections were followed-up with hysterectomy. Four cases were with conservative management. From all the hysterectomy performed, four were complicated with bladder injury. The mean intraoperative bleeding was 600 - 5500 cc of blood, while the mean of post-operative transfusion was 1000 -3000 cc. There were 2 maternal deaths in this study. Thirteen patients were admitted to the ICU after the procedure.Conclusion: Accreta increases morbidity due to massive bleeding. It is important to have algorithm for managing abnormal implantation of the placenta. Our cases revealed no significant results of maternal outcome between conservative surgery and conventional hysterectomy in managing accreta cases in Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Feasibility Study For Birth Defect’s and Congenital Abnormalities’s Integrated Service In A Low-Middle Income Country Saroyo, Yudianto Budi; Firmansha Dilmy, Mohammad Adya; Salsabila Putri, Cut Tisya; Islamah, Rachelya Nurfirdausi; Budiman, Jenica Xaviera; Rumondang, Amanda; Purwosunu, Yuditiya; Irwinda, Rima; Rohsiswatmo, Rinawati
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 3 July 2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i3.2783

Abstract

Background: Congenital abnormalities are anatomical and physiological abnormalities that are present in babies from birth. One of the main causes of high infant mortality and neonatal mortality in Indonesia is congenital abnormalities in babies. This study describes the prevalence of congenital abnormalities in Dr. Cipto Mangunkusumo Hospital, as a tertiary referral hospital in Indonesia, which requires integrated healthcare service to be treated well. Methods: Data obtained from 323 patients at Dr. Cipto Mangunkusumo General Hospital are collected in a year, to be further analyzed in retrospective cohort study. Collected data includes the patients’ age, birth date, reproductive history, gestational age, and congenital abnormalities of the baby. Results: The data shows that patients with the age group of 30-39 years old dominated the cases of pregnancy with congenital abnormalities. Cases are also more dominant in the gestational age of 13 – 28 weeks (second-trimester). Most cases of abnormalities are from the central nervous system with 159 cases and followed by cardiovascular system with 130 cases. Overall prevalence of congenital abnormalities are detected within patients during prenatal screening in Dr. Cipto Mangunkusumo General Hospital. Conclusion: This study highlights the importance in managing congenital abnormalities and birth defects by developing an integrated service in the healthcare system to lower infant and neonatal mortality. Keywords: birth defect, congenital abnormalities, prenatal screening
Placental Vitamin D, Oxidative Stress, and Senescence Markers in Spontaneous Preterm Birth: A Comparative Cross-Sectional Study Yudianto Budi Saroyo; Noroyono Wibowo; Damar Prasmusinto; Yuditiya Purwosunu; Rima Irwinda; Mohammad Adya Firmansha Dilmy; Atikah Sayogo Putri; Arya Ivan Mahendra; Lysandra Olivia Prasanti Putri
Indonesian Journal of Obstetrics and Gynecology Volume 14. No. 1 January 2026
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v14i1.2928

Abstract

AbstractObjective: To evaluate the associations between vitamin D metabolism markers and biomarkers of oxidative stress and placental senescence among women with spontaneous preterm labor compared with those with term labor. Methods: We conducted a comparative cross-sectional study between 2017 and 2019 in two hospitals in Jakarta, Indonesia. Maternal serum and placental samples were collected from women with term labor and spontaneous preterm labor. Markers of the vitamin D pathway 25-hydroxyvitamin D (25[OH]D), 1,25-dihydroxyvitamin D? (1,25[OH]?D?), vitamin D receptor (VDR), and CYP27B1 along with oxidative stress (8-hydroxy-2--deoxyguanosine [8-OHdG]) and placental senescence markers (GLB1 and HMGB), were measured using ELISA, LC–MS/MS, and ICP–MS. Between-group comparisons were performed using parametric or nonparametric tests, as appropriate, and correlations were assessed using Pearson’s or Spearman’s correlation coefficients. Results: A total of 67 women were included (term labor, n = 34; spontaneous preterm labor, n = 33), and both groups were vitamin D deficient. Placental 1,25(OH)?D? levels were significantly lower in the preterm group than in the term group (4.58 ± 2.90 vs 5.57 ± 3.50 pg/ng, p = 0.037). Placental VDR levels also differed significantly between groups {21.70 (6.06–73.40) vs 16.48 (1.87–74.67), p = 0.041}. Across all participants, 8-OHdG and placental senescence markers were negatively correlated with placental 25(OH)D and 1,25(OH)?D? levels and positively correlated with placental CYP27B1 and VDR expression. Conclusion: In this comparative cross-sectional cohort, placental vitamin D metabolites were associated with lower levels of oxidative stress and placental senescence biomarkers, whereas VDR and CYP27B1 showed positive associations with these biomarkers. These patterns may reflect compensatory regulatory mechanisms in the context of maternal vitamin D deficiency. These findings are hypothesis-generating and warrant confirmation in prospective studies and mechanistic investigations. Keywords: oxidative stress, placental senescence, spontaneous preterm labor, vitamin D.